View full sizeBeth Nakamura/The OregonianAlexandra Malusevic kisses newborn son, Max, who arrived March 30, weighing 10 pounds, 10 ounces. Despite the many worries since Alex was struck by a hit-and-run driver in a downtown Portland crosswalk.

Reclining on a padded table in a Northwest Perinatal Center exam room, Alexandra Malusevic watched grainy pictures of the fetus growing in her womb flash across a video monitor.

David Sproat, the baby's father, sat next to her, holding Alex's hand and repeating one word -- "Wow!" -- as the ultrasound images revealed tiny fingers, toes, eyes, mouth and four little chambers of the heart.

Seven weeks had passed since a car ran over Alex in a downtown crosswalk, missing her belly by inches. She'd endured surgeries to repair a broken ankle and to extract a potentially deadly blood clot from her heart. Fractures in her pelvis and spine were still healing. Yet, her baby appeared robust.

He was all Alex hoped to focus on during that last month of her pregnancy.

The series

Last year, 62 pedestrians died in Oregon, a nearly 60 percent increase from 2009. During the first week of 2011, when a driver plowed into Alexandra Malusevic in a downtown Portland crosswalk, she wondered whether she and her unborn child would become statistics, too.

Given her traumatic injuries and accompanying complications, she knew her original plan for a water birth, attended by a midwife, wouldn't fly. But she hoped to get through labor without painkillers and deliver her child the old-fashioned way, rather than by cesarean-section.

When her ultrasound appointment wrapped up, Alex climbed off the table and into a wheelchair. David pushed her back to the waiting room. She was due to see her perinatalogist next and planned to ask about an infection she'd developed in the surgically repaired ankle.

Dr. Debra Guinn didn't like the looks of it. She thought Alex might have cellulitis, a serious bacterial skin infection, and admitted her that afternoon to Providence St. Vincent Medical Center.

A dermatologist, who examined her head-to-toe, took tissue samples from her ankle and removed a suspicious mole from Alex's right thigh. The tissue samples showed the infection was nothing serious. But lab results on the mole delivered a shock:

Alex had Stage 2 melanoma, the most dangerous type of skin cancer.

"Are you kidding me?" she remembers asking. "Really? On top of everything?"

Her doctors wanted to do a sentinel-node biopsy to see whether the cancer had spread, but that required injecting Alex with radioactive dye. They couldn't do that while she was pregnant.

Just as before her open-heart surgery, they wondered whether they should take the baby immediately by C-section.

HOW TO HELP

Friends of Alex Malusevic and David Sproat are raising money to help the couple defray medical expenses not covered by insurance.

Donations can be made to the “Alexandra A. Malusevic” donation account at any U.S. Bank branch.

Solih Birka Tufa hung his head as he told Multnomah County Circuit Judge Michael McShane he was guilty. He'd been behind the wheel of the black Nissan Pathfinder that hit Alex on Jan. 5, then fled.

His lawyer, Jason Short, elaborated, telling the court that his 23-year-old client made a bad decision but was a good person. Tufa attended Portland Community College and Portland State University, studying to be a physician assistant. A naturalized citizen, he came to the United States from Ethiopia at age 12 and worked as a volunteer mentor in Portland's refugee community.

"This is not characteristic of him," Short said.

Tufa stood to read an apology letter but only got through the first sentence before he broke down sobbing.

Short continued for him: "... I accept full responsibility for my behavior. I am so sorry for leaving you there. ..."

Alex wasn't in the courtroom. With her due date only a couple of weeks off, she didn't want the stress.

Kim Phillips-Clark, a victim advocate, read a letter Alex wrote to Tufa. In part, it Said, "Am I angry? Of course ... However, I am not a vengeful person. Although I feel wronged, I do not wish bad things on you. I believe no good can come of that ... I can only hope ... that you will learn from your mistakes ..."

Tufa's sentence: 60 days in jail; three years probation; a suspended license for one year; $5,000 in restitution.

Deputies handcuffed him and led him away.

In the back row, his mother wept.

*****

View full sizeBeth Nakamura/The OregonianAlexandra Malusevic (center) and her partner, David Sproat, watch images from her womb projected on a video screen as Jamie Wheeler conducts an ultrasound at Northwest Perinatal Center.

Alex's doctors decided the biopsy and cancer treatment could wait. No cancer showed up on a CT scan after the collision, so it might not have spread.

With a temporary reprieve, she could get back to the business of planning her baby's birth. She couldn't help but wonder: If she'd never been hit by a car, would the cancer have been discovered too late?

Eight of David's co-workers from the energy company Iberdrola Renewables helped move the couple from a one-bedroom apartment to a two-bedroom; many colleagues donated time so he could stay home with Alex as she recovered from her injuries.

As David unpacked, Alex rested.

Ten days before her March 24 due date, Jen Sanders, a doula, visited Alex at home. They talked about everything from strategies for easing labor to breastfeeding. Alex told Jen that while her doctor didn't think her pelvic fractures would prevent her from delivering naturally, she warned that a C-section was still possible.

She told the doula that while she was grateful for all the excellent medical care she'd received, she wasn't crazy about doctors taking control over her child's birth.

Jen encouraged Alex to write a birth plan, spelling out what she wanted once she was in labor -- and what she didn't want. Listening intently, Alex stroked her bulging belly.

She described a dream in which she had one contraction, gave birth instantly and immediately put the baby to her breast.

She said: "I'm getting down to the wire here."

Thursday, March 24, came and went, not a contraction in sight.

Alex's obstetrician told her that if she wasn't in labor by Tuesday the 29th, she'd need a C-section. The baby would get too big to deliver naturally.

Tuesday, Alex's cervix was dilated to 4 centimeters, indicating active labor. Guinn admitted her to St. Vincent's, and at 5 a.m. the next day, a nurse hooked her up to a Pitocin drip. By 7 a.m. Alex felt labor's powerful contractions, enduring them as she'd planned, without painkillers. They hurt, she remembers, but didn't compare to the pain she felt when the SUV ran over her.

By afternoon, her cervix was dilated to 9 centimeters, 1 centimeter shy of where it needed to be. She fought the urge to push.

Examining her, Guinn discovered that the baby was slightly tilted; she tried, but was unable to turn his head into the correct position. She told Alex she wanted to do a C-section before the situation turned into an emergency.

Exhausted, Alex remembers saying, "If you think it's best, then that's what we should do."

Doctors used spinal anesthesia, so Alex was awake but groggy. David held her hand. A drape shielded her belly, so neither could see what was happening.

They heard a cry, the first from Maximilian -- their boy, Max.

Ruddy-cheeked, dark-haired, with full lips and blue eyes, he was 22 inches long and a whopping 10 pounds, 10 ounces.

Swaddled in a blanket and resting in his mother's arms two days later, he clasped one of her fingers with his powerful little hand.

Gazing at him and kissing his forehead, Alex said, "I knew you were gonna be strong."